VINCENT PAUL GIBBONS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

VINCENT

Middle

PAUL

Last Name

GIBBONS

Suffix

Business Name

VINCENT PAUL GIBBONS MD

Original Issue Date

11/04/1997

Effective Date

05/01/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021